Governments blame citizens for their own policies. The modern ideology of individualism and personal responsibility adopted by governments has allowed them to push the idea that their citizens must take responsibility for their own lives and be responsible for their own decisions, and therefore for the consequences of those decisions. That means they can be blamed for ill health, their accommodation and other aspects of their lives. Governments do acknowledge certain limits to that claim. They accept that some health conditions are genetic or due to bad luck, that addiction makes responsible behaviour problematic – but these are limits at the margins. Citizens are responsible for their actions, but can only be held responsible for making reasonable choices from the menu of opportunities they face. Government is the major agent setting that menu. In most areas of life, government is responsible for social outcomes, be they good or bad.

The personal responsibility agenda fits with the idea that government should not be trusted. Government should be minimal, meaning its regulations are light or non-existent. However, that simply means that large corporations and powerful individuals can act irresponsibly with no accountability. We see that with food manufacture, with the arms trade and in the gambling industry. We also see it in the finance and banking industries. In other areas, including housing, individual actions prompted by the financial incentives set up by governments have led to a crisis where the poor have no dwellings to live in at all, and the young middle class cannot afford to buy homes as their parents and grandparents did. Government is to blame. I will first review my arguments in the areas I have examined and then look at a set of criticisms that might be levelled at my argument.

Review

I have looked at some policy areas where we might think that government regulatory policies are problematic: gun control, obesity, housing, gambling and drugs. We might also have considered myriad others – transport, the environment, sports policy, gender discrimination in the workplace – or the big one that may make all the rest seem trivial: climate change. The topics I have chosen to discuss were picked for two reasons. First, they are all relatively small or enclosed policy areas where the regulatory issues are comparatively self-contained. Second, I selected these particular ones in order to illustrate different aspects of my argument.

Much of this book has been arguing that government has reneged on its responsibility to its citizens by claiming, in the name of liberty, that they need to take responsibility for what happens to them. I have maintained that, generally speaking, citizens cannot be held responsible for many of the bad social outcomes which we witness in society today. Individuals can only be held responsible for the choices they make given the situation in which they find themselves. Government is largely responsible for their situation. I have also argued that there are certain features about human biology that mean we know that people will tend to respond to certain sorts of incentives. Government should be aware of those responses and, rather than simply throwing blame or responsibility on to individuals, it ought to design policy that helps people.

This chapter is about drugs policy. In the main it is about recreational drugs, but occasionally I will also contrast the manner in which government designs and implements policies on recreational drugs with how it deals with drugs produced for medical purposes – what I will refer to as ‘medical drugs’. While governments are keen not to be too paternalistic in many fields, their attitudes to recreational drugs are highly paternalistic. We can contrast recreational drug policies with gambling, where the paternalistic policies of the past have given way to a more libertarian outlook. In the main, this has been welcome, but it has created a bigger class of problem gamblers. I argued that government needs to recognize that a large degree of problem gambling results from liberalization and it needs to take responsibility for that, particularly noting that addiction deprives an individual of full responsibility for their actions. Government must acknowledge its duty to help problem gamblers, especially since their problem has deleterious effects not only for themselves but also their families.

Governments are still paternalistic when it comes to recreational drugs. Most recreational drugs are criminalized, in producing, selling, buying or consuming – sometimes in all aspects. The majority of those who work in drugs policy – not only academics doing research, but also many who work in the field with addicts, as well as many senior police officers, public servants and, often privately, politicians – believe that the criminalization of recreational drugs is a failed public policy.

There is no doubt that, in the developed world, people, by various measures, are healthier than they have ever been. Mortality and morbidity rates have fallen over the past century or more, notwithstanding occasional blips when crises such as war or economic depression have halted or temporarily reversed gains. The crude death rate in the US, for example, has fallen from around 1 per cent to about 0.8 per cent since the 1940s, but the age-adjusted rate has fallen much more quickly. People on average live longer, since fewer people die young.

This trend is a global phenomenon; and the biggest falls in death rates have occurred in countries with the fastest economic growth rates. We know that mortality and morbidity rates are correlated with per capita gross domestic product (GDP), although the quite large variation across countries shows that other factors are also important. We know, too, that mortality and morbidity rates vary across social classes, with the rich living longer and, on average, having better health than poorer people. We can further note that, while this increase in the health of the world's population is enhanced by better health care (that is, the provision of medical services), the major cause is healthier lifestyles due to better food, water and living conditions.

Despite this good news for people's health, there is growing concern in the developed world about increasing obesity among the population. This was first brought to public attention by health professionals – the World Health Organization was a major player in publicizing the issue – but it is increasingly discussed by politicians, commentators and the public.

The issue has been described as a crisis, and obesity as an epidemic. These rhetorical flourishes are to be expected when an issue is first brought to public attention. In themselves, they are not very helpful descriptions. The scale of the obesity crisis is highly contested, with some people suggesting we should not concern ourselves with body shape. The manner in which it is discussed also varies cross-nationally. In the UK, for example, the costs to the taxpayer-funded NHS are a concern. Obesity therefore becomes a public issue, since those not suffering health problems due to excess weight subsidize the health costs of those who are.

This book was researched and drafted in 2019, and the use of data and evidence reflects that. It grew from my increasing frustration with how governments in many parts of the world, notably Australia, the US and the UK, the three countries I know best, continually blame citizens for what I see as government failure. Just as I was delivering the manuscript to the publishers in December 2019, coronavirus disease 2019 (COVID-19) was first identified in Wuhan in China's Hubei province. From the start there was some discussion in the media about how dangerous it might be and whether it posed a threat of pandemic, but this was all rather low key. As early as January 2020, some countries were taking actions against the risk of such a pandemic, but these were in South East Asia. Europe, Australia, Africa and the Americas did not seem too concerned. Some governments were planning behind the scenes, others were not.

By March 2020 it was becoming clear to everyone that COVID-19 was a pandemic that required drastic action. As I write now, in late April 2020, it is clear that governmental responses to COVID-19 have varied widely. Some countries, when they acted, did so decisively, others not. Furthermore, the strategic response has differed.

Some countries closed borders and ordered lockdowns quickly to stop the spread of the disease. Some have taken a more relaxed attitude, providing citizens with advice on hygiene and physical distancing, but have not enforced lockdowns. Singapore, for example, took early tough action on entry into the country and shut down businesses and schools. New Zealand also took relatively swift and dramatic action. Both countries, as of April 2020, have been widely praised for their actions. Sweden has taken a different line. It encouraged citizens to be careful and to maintain some physical distance, but has not enforced lockdowns. Its rate of infection and its mortality rate are both higher than in countries with stricter conditions, notably similar neighbouring countries such as Norway and Finland. As I write, Swedish experts and the government there are still defending their policies, arguing that their superior health service has not been overwhelmed as it has in some countries and that we will not really be able to tell for several years, after later waves, and economies had a chance to recover, which policy, ultimately was best.

Recent decades have seen a rise in homelessness through much of the Western world. In Australia, levels increased by almost five per cent from 2011 to 2016. On census night in 2016, 116,000 people were homeless; that is a rate of 5 per 1,000 people. Who is responsible? ‘Get a good job that pays good money’, said Joe Hockey, the Australian treasurer, to young people complaining they could not get a start in the inflated housing market – or get your parents to buy them for you, the Australian prime minister chipped in.

Gun crime in the US frequently makes headlines around the world. Between 2014 and 2018, according to the Gun Violence Archive, there were 71,429 deaths and 113,947 injuries in gunrage incidents: an average of 14,286 deaths and 22,590 injuries per year. Who is to blame? Again, according to some leading US politicians, it's citizens who are to blame. The bad guys. Guns don't kill people, people do, the argument runs (and some of those killers are only three years old). Some go further and say the solution to gun crime lies in more weapons: ‘The only thing that stops a bad guy with a gun is a good guy with a gun’.

Obesity levels are rising sharply internationally. In the UK about 28 per cent of the population are thought to be obese, with a further 35 per cent overweight. In the UK obesity is estimated to reduce life expectancy by about three years. Obesity costs the National Health Service (NHS) about £5 billion per year, with the costs to the economy estimated to be £27 billion per annum. The government response to growing obesity is health campaigns advising people to be careful about what they eat, and to take more exercise. It is as if the rise in obesity has nothing to do with modern methods of food manufacture developed in the 1960s and 1970s; methods that the government has barely regulated. It is the choice of people to eat the food that is widely available in the shops, not the government that regulates what is sold in shops, that is to blame for the obesity crisis.